title: Depressive symptomatology as a risk factor for increased health service utilization among elderly patients in primary care.
abstract: Depression may play an important role in determining frequent physician visits in the older population. Our aim is to examine the relationships between socio-demographic variables, co-morbidity, memory complaints, functional status, depressive symptomatology, and health care utilization among community dwelling older patients. The study was conducted in urban primary health care clinics in Beer-Sheva, Israel. Two groups were identified: low care utilizers (LCU), with ≤ 6 visits to family physicians (FP)/year and high care utilizers (HCU) with ≥ 16 visits to FP/year. Data were collected during a structured face-to-face individual interview. The study population included 180 patients, of them 86 (47.7%) were LCU and 94 (52.2%) were HCU. In all clinical measurements the HCU group indicators were statistically significant worse off than the LCU group: average depressive symptoms (5.6 vs. 2.5, p<0.01), memory complaints (57.5% vs. 23.3%, p<0.01), Barthel Index (BI) (89.9 vs. 96.0, p<0.001), OARS (10.8 vs. 12.5, p<0.01), and co-morbidity: total cumulative score (TCS) of Charlson comorbidity index (CCI) (2.2 vs. 1.3, p<0.01). Our study raises the possibility that at least one of the reasons for over-utilization of health services by older residents in the community is depressive symptomatology.
authors.affiliation: Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, POB 653, Beer-Sheva 84105, Israel. yanp@bgu.ac.il
authors.forename: Yan
authors.initials: Y
authors.lastname: Press
authors.forename: Howard
authors.initials: H
authors.lastname: Tandeter
authors.forename: Pnina
authors.initials: P
authors.lastname: Romem
authors.forename: Ruth
authors.initials: R
authors.lastname: Hazzan
authors.forename: Miri
authors.initials: M
authors.lastname: Farkash
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D003863:Depression / Q000175:diagnosis*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D007557:Israel; D008297:Male; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012111:Residence Characteristics; D012307:Risk Factors; D014505:Urban Population